Download presentation
Presentation is loading. Please wait.
Published byMaximilian Davidson Modified over 9 years ago
1
Medical Benefit Overview
2
Health Care Reform Employee Benefit Plans Health Savings Accounts (HSA’s) Open Enrollment
3
Offer coverage to full-time employees Imposed taxes / fees on benefit plans offered by employers All individuals are required to have health insurance Health Care Reform 3
4
Full-time employees are eligible Offered by Blue Cross Blue Shield of Michigan (BCBSM) and OnStaff BCBSM offers additional benefits to members Benefit plan is compatible with a Health Savings Account (HSA)
5
Deductible: the amount of eligible expenses a member must pay each year before the health plan will make payment for eligible benefits. Note: The full family deductible must be met under a two-person or family contract before benefits are paid for any person on the contract. Coinsurance: a fixed percentage amount that a member is responsible to pay. Coinsurance applies after your annual deductible has been met. Out-of-Pocket Maximum (OOPM): the maximum amount a member pays in a calendar year. The OOPM includes deductibles and coinsurance. 5 Definitions
6
CoverageIn-NetworkOut-of-Network Deductible (Single / Family) $6,350 / $12,700$12,700 / $25,400 Coinsurance100%80% Out-of-Pocket Maximum (Single / Family) Includes deductible and coinsurance $6,350 / $12,700$15,000 / $30,000
7
CoverageIn-NetworkOut-of-Network Preventive Care100%Not covered Office Visit 100% after deductible 80% after deductible Urgent Care 100% after deductible 80% after deductible Emergency Room 100% after deductible 100% after network deductible Prescription 100% after deductible 80% after deductible Hospital 100% after deductible 80% after deductible
8
Search the BCBSM PPO Network online at www.bcbsm.com (Note: For employees who reside outside of Michigan, search the BCBS national network at www.bcbs.com)www.bcbs.com Contact BCBSM’s customer service Ask the biller at your doctor’ office
9
BCBSM.com allows members to: View benefit coverage Review claims App for your mobile device Order ID cards Note: For those who live outside of Michigan, you will still access your member benefits through BCBSM.com Nurse available 24/7 Healthy Blue Xtras
10
Plan being offered is qualified high deductible health plan (HDHP) Health Savings Accounts (HSA’s) are tax-advantaged savings accounts that can accompany a HDHP Allows you to save money to cover health expenses Account grows through tax-deferred investment earnings Funds remain in the account from year to year, just like an IRA
11
Maximum contribution amounts for 2015 Single - $3,350 Family - $6,650 HSA Vendors Lake Michigan Credit Union – (800) 242.9790 HSA Authority – (888) 472.8697 Check your local bank for HSA options Note: In order to contribute to an HSA, you cannot be covered by another type of insurance (unless it’s a dental or vision plan, or another qualified HDHP).
12
ContractMonthly Single$101.29 Two-Person$558.12 Family$753.91
13
Complete enrollment form if electing benefit plan Complete waiver form if declining coverage Your form must be completed and turned in to Human Resources during the orientation period
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.